title: Descemet's stripping and non-Descemet's stripping automated endothelial keratoplasty for microcornea using 6.0 mm donor grafts.
abstract: BACKGROUND
  The purpose of this paper is to report our experience of Descemet's stripping and non-Descemet's stripping automated endothelial keratoplasty (DSAEK/nDSAEK) for microcorneas using 6.0 mm donor grafts.
  
  
  METHODS
  Three eyes of two patients (a 56-year-old woman and a 59-year-old woman) with microcornea and suffering from bullous keratopathy were treated with either DSAEK or nDSAEK. A small donor graft (6.0 mm) was inserted into the anterior chamber using a double glide (Busin glide and intraocular lens sheet glide) donor insertion technique. Both patients were followed for at least 12 months. Clinical outcomes, including intraoperative and postoperative complications, visual acuity, and endothelial cell density were evaluated.
  
  
  RESULTS
  In all three cases (100%), no intraoperative complications were noted. In one case with a flat keratometry value (32.13 D), a partial donor detachment was noted one day postoperatively, but it was reattached by rebubbling. In another case, rejection was noted 8 months postoperatively, but treatment with systemic corticosteroids was successful. A clear cornea remained in all three cases (100%), with best-corrected visual acuity greater than 20/100 (mean 20/50) at 12 months. Mean postoperative endothelial cell counts were 2,603 ± 18 cells/mm(2) at 6 months (7.4% decrease from preoperative donor cell counts) and 1,799 ± 556 cells/mm(2) at 12 months (36.5% decrease).
  
  
  CONCLUSIONS
  We report for the first time the successful use of a small donor graft (6.0 mm) for DSAEK/nDSAEK in cases of microcornea. Additional stud ies using a large number of patients are required to evaluate fully the potential advantages and drawbacks of small diameter donor grafts for microcornea.
authors.affiliation: Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yokogawa
authors.forename: Akira
authors.initials: A
authors.lastname: Kobayashi
authors.forename: Natsuko
authors.initials: N
authors.lastname: Yamazaki
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Ueta
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Naoko
authors.initials: N
authors.lastname: Tachi
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Sugiyama
keywords: Descemet’s stripping; automated endothelial keratoplasty; microcornea; non-Descemet’s stripping; small donor grafts